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Why is harm reduction (HR) still rejected in much of the U.S.? MacCoun (1998) suggested two categories of HR objectors Some objectors just don’t know enough about HR to favor it Implication: They can be persuaded by data-based evidence e.g., Goddard (2003): Midwestern mental health and addiction treatment professionals had more favorable attitudes toward HR after a continuing education presentation about it

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Why is harm reduction (HR) still rejected in much of the U.S.? Other objectors, especially conservatives, may have a visceral sense that drug use violates the purity or sanctity of the body They may see drugs, drug use, drug users, and harm reduction as disgusting

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Roots of conservative opposition to HR Relative to liberals, conservatives are more likely to consider these dimensions when making moral decisions Purity or sanctity Respect for authority Ingroup loyalty

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Roots of conservative opposition to HR Drug use and harm reduction may violate each of these dimensions Purity or sanctity “The body is a temple and drugs defile it” Respect for authority “Drug use is against the law” Ingroup loyalty “None of my friends are drug addicts”

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The Current Study’s Hypotheses We tested the hypothesized conceptual connections in a correlational study We predicted significant correlations among measures of attitudes toward drug/alcohol use and HR with measures of sensitivity to disgust use of purity, authority, and ingroup loyalty in moral judgments political conservatism

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Participants We administered the measures online (via SurveyMonkey) to students at Northern Kentucky University, who earned course credit 343 accessed the study’s website 80 were excluded for excessive missing data or for missing two validity items Final sample: N = 263 Mean age: years 67% were female 60% were freshmen 90% were white

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Measures Attitudes toward drug and alcohol use Temperance Mentality Questionnaire Nobody who drinks really benefits from it. Attitudes toward HR Harm Reduction Acceptability Scale-Revised Abstinence should be the only acceptable treatment goal for people who use illegal drugs. Sensitivity to disgust Three-Domain Disgust Scale Standing close to a person who has body odor.

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Measures Relevance of purity, authority, and ingroup loyalty to moral judgments Purity: Whether or not someone acted in a virtuous or uplifting way. Authority: Whether or not someone showed a lack of respect for legitimate authority. Ingroup Loyalty: Whether or not someone put the interests of the group above his/her own. Political conservatism Political Ideology Scale Strongly Liberal (-3) to Strongly Conservative (+3)

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Conclusions The more disapproving participants’ attitudes toward drug/alcohol use and harm reduction are, the more sensitive they are to disgust the more relevant are issues of purity, authority, and ingroup loyalty to their decisions about right and wrong, and the more politically conservative they are

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Implications This group’s objections to harm reduction may not be readily amenable to persuasion with the usual data-based arguments Perhaps they’re the 47% we’ll never convince Or perhaps we need to frame harm reduction in such a way that we address their concerns e.g., HR as a way of achieving good health, order, and happiness in our communities Figuring out how to reach these HR opponents remains a major challenge for the future